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December 1985

Local Steroids in Dialysis-Associated Pericardial Effusion: A Single Intrapericardial Administration of Triamcinolone

Author Affiliations

From the Renal (Drs Quigg, Idelson, Yoburn, Hymes, and Bernard) and Cardiology (Dr Schick) Sections, Department of Medicine, Evans Memorial Department of Clinical Research, University Hospital, Boston University Medical Center. Dr Yoburn is now with the Joslin Diabetes Center, Boston.

Arch Intern Med. 1985;145(12):2249-2250. doi:10.1001/archinte.1985.00360120121021

• Five patients receiving maintenance hemodialysis for end-stage renal disease underwent therapeutic pericardiocentesis for pericarditis manifested by either cardiac tamponade or effusion unresponsive to conservative therapy. Pericardiocentesis was followed by a one-time instillation of triamcinolone hexacetonide, a nonabsorbable corticosteroid, into the pericardial space with subsequent needle withdrawal. All patients had prompt hemodynamic and symptomatic improvement. Serial echocardiograms showed resolution of the pericardial effusion in all patients. Follow-up evaluation for six months to six years has shown no clinical or postmortem evidence of recurrence. This procedure appears safe and effective and potentially can obviate the need for prolonged catheter drainage or more invasive surgical procedures as therapy for these patients.

(Arch Intern Med 1985;145:2249-2250)

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